Organization Active NPI

Williams & Williams Chiropractic Clinic

  • Chiropractor
  • Jackson, TN
National Provider Identifier
1245441963
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
313 Issued in TN
Legal business name
WILLIAMS & WILLIAMS CHIROPRACTIC CLINIC
Practice address
30 Lynoak CV
Jackson, TN 38305-2800
Phone
(731) 664-7955
Fax
(731) 668-4795
NPI assigned
May 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Debe Elaine Williams, D,C,NPI 1619910072
Title
President
Phone
(731) 664-7955

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 313 TN Primary

Addresses

Primary practice location

30 Lynoak CV
Jackson, TN 38305-2800

Mailing address

30 Lynoak CV
Jackson, TN 38305-2800
Phone (731) 664-7955

Other identifiers 1

IdentifierTypeStateIssuer
3677135MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111109000447 TN Part B Supplier - Clinic/Group Practice 9234302175 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson, TN

National Provider Directory

National Provider Directory

Locations

30 Lynoak Cv
Jackson, TN 38305
Phone (731) 664-7955

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1245441963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 LYNOAK CV",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052800",
            "telephone_number": "731-664-7955",
            "fax_number": "731-668-4795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 LYNOAK CV",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052800",
            "telephone_number": "731-664-7955",
            "fax_number": "731-668-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMS & WILLIAMS CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DEBE",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "731-664-7955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D,C,"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3677135",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.